Evaluation of a Combined Cognitive Behavioural Therapy and Interpersonal Process Group in the Psychotherapy Training of Clinical Psychologists

It is now widely acknowledged that both content and process elements of psychotherapy play a part in client treatment outcomes. Despite this, there are pressures on Australian clinical psychology training programs to teach evidence‐based approaches in a relatively short time frame. Producing clinical psychology graduates who have an adequate level of competence in evidence‐based practice and meeting the demands of professional accreditation requirements can mean that less time is available to teach the process elements of psychotherapy. The aim of this study was to conduct a preliminary evaluation of a clinical psychology psychotherapy training program that combines an interpersonal process group with a cognitive behavioural therapy training model that incorporates self‐reflection and self‐practice. Eleven participants who participated in the training in 2008 completed the Counseling Self‐Estimate Inventory at pre‐ and post‐training. Significant improvements on the majority of the subscales of this inventory were found. A separate sample of nine trainees and clinical psychology registrars who also previously completed the program attended individual interviews in 2010 aimed at gaining their perspective regarding various aspects of the program. Self‐practice of cognitive behavioural therapy techniques was found to be important in the identification and management of trainees’ own core beliefs, and to their appreciation of how challenging this process may be for clients. The interpersonal process group was described by participants as enhancing their competency as psychotherapists. Common themes included the experience of anxiety and a high level of emotion, and understanding how this experience might be similar for clients; increased self‐awareness; and increased competence in process issues. Many participants believed the process and content components of training were equally important to their development as psychotherapists.     

Stress in Clinical Psychology Trainees: Current Research Status and Future Directions

The purpose of this article is to present the current status of the literature related to stress in clinical psychology trainees (CPTs), and to offer research directions for investigating stress in this population and ways to enhance self‐care in these individuals. The following conclusions emerge from the review: (1) CPTs are vulnerable to elevated stress; (2) undue stress can negatively impact CPTs' personal and professional functioning and, in turn, result in less than optimal standards of care for clients; (3) there is a dearth of studies on stress in this population and no published intervention studies; (4) incorporating self‐care strategies into clinical psychology training is recommended; and (5) “third‐wave” cognitive behaviour therapy stress management interventions have been efficacious in comparable populations. In view of the potential costs of elevated stress to trainees themselves and their clients, research on stress and stress management in this population is of a high priority. Broad research agendas are proposed for these two domains. Modifications to clinical training programmes to reduce trainee stress are required and should be evidence‐based and systematically revaluated.     

Clinical Psychology Students’ Experiences of a Pilot Objective Structured Clinical Examination

There is a need to improve methods used to assess students’ clinical skills in postgraduate clinical psychology training, but research into the use of new competency‐based assessments are sparse. The current study examines the potential application of the objective structured clinical examination (OSCE) to clinical psychology training. Commonly used in medical training, the OSCE requires students to demonstrate clinical skills across a number of standardised stations with trained actors playing the part of patients. A pilot OSCE was conducted with nine students from a psychology doctoral program. Participants completed a brief student feedback questionnaire and attended a focus group after the OSCE. They also completed the State–Trait Anxiety Inventory before and after the OSCE. The results showed that students viewed the OSCE as a valid, realistic, and fair assessment method. They reported high levels of anxiety during the OSCE but noted that the OSCE was a positive learning experience. These results suggest that OSCEs should be considered in clinical psychology training programs for the assessment of clinical competence. Further evaluations of the validity and reliability of the clinical psychology OSCE using a larger sample size are required. Other limitations and implications of the study are discussed.     

认知诊断缺失数据处理方法的比较：零替换、多重插补与极大似然估计法

数据缺失在测验中经常发生, 认知诊断评估也不例外, 数据缺失会导致诊断结果的偏差。首先, 通过模拟研究在多种实验条件下比较了常用的缺失数据处理方法。结果表明：(1)缺失数据导致估计精确性下降, 随着人数与题目数量减少、缺失率增大、题目质量降低, 所有方法的PCCR均下降, Bias绝对值和RMSE均上升。(2)估计题目参数时, EM法表现最好, 其次是MI, FIML和ZR法表现不稳定。(3)估计被试知识状态时, EM和FIML表现最好, MI和ZR表现不稳定。其次, 在PISA2015实证数据中进一步探索了不同方法的表现。综合模拟和实证研究结果, 推荐选用EM或FIML法进行缺失数据处理。     

Brief Cognitive-Behavioral Therapy for Suicide Prevention (BCBT-SP) via Video Telehealth: A Case Example During the COVID-19 Outbreak

Although veterans living in remote/rural areas are at elevated risk for suicide, there is very little research specific to treating suicidal veterans who present with barriers to in-person care. The current study aims to examine the delivery of brief cognitive-behavioral therapy for suicide prevention (BCBT-SP) via Clinical Video Telehealth (CVT) to the home of a veteran discharged from the psychiatric inpatient unit after a recent suicide attempt. Preliminary data on acceptability, feasibility, and changes in symptoms were gathered. The veteran received treatment during the 2020 COVID-19 outbreak and additional adaptations were made accordingly. The veteran did not engage in any suicidal behavior during the course of treatment, and suicidal ideation, depression, and anxiety decreased as treatment progressed. The results provide initial support for the feasibility of BCBT-SP via CVT to the home.     

人工智能辅助的自闭症早期患者的筛查与诊断

自闭症谱系障碍(Autistic Spectrum Disorders, ASD)的症状早在婴幼儿期就会显现, 越早发现, 越早干预, 治疗效果越好。传统自闭症早期筛查与诊断在评估方法、流程上存在局限, 无法满足大规模筛查和诊断需求。随着人工智能技术的快速发展, 使用智能化方法进行自闭症早期大规模无感筛查与诊断逐渐成为可能。近10年间, 国内外对自闭症智能化识别方法的探索在经典任务行为、面部表情和情绪、眼动、脑影像、运动控制和运动模式、多模态6个领域积累了丰富的研究成果。未来研究应围绕构建国内自闭症早期智能医学筛查与诊断体系, 开发针对婴幼儿患者的筛查工具, 构建融合多模态数据的自闭症婴幼儿智能化识别模型, 建立结合脑影像技术的自闭症精细化诊断方法等方面来开展。     

Bion's Notes on memory and desire – its initial clinical reception in the United States: A note on archival material

While Bion's 1967 memory and desire paper reflected a crucial episode in his clinical thinking during his epistemological period, it was also central to his evolution as a Kleinian psychoanalyst who worked with seriously disturbed adult patients. The author explicates and contextualizes these claims with a new archival document, the Los Angeles Seminars delivered by Bion in April 1967, and the full‐length version of Notes on memory and desire. Bion here instigated a radical departure from years of theory‐laden work when he made his clinical work and ideas accessible to a new audience of American Freudian analysts. While this new group was keenly interested to hear about Bion's clinical technique with both borderline and psychotic patients, there were varied reactions to Bion's ideas on the technical implications of the analyst's abandonment of memory and desire. Both the Los Angeles Seminars and Notes elicited responses ranging from bewilderment, admiration to skepticism amongst his audience of listeners and readers. These materials also however allow for a more complete and systematic presentation of important ideas about analytic technique – and while his ideas in this domain have been long valued and known by many psychoanalysts, this contribution stresses the crucial aspect of the reception of his ideas about technique in a particular American context. American analysts gained a much more explicit idea of how Bion worked analytically, how he listened, formulated interpretations and factored in the analyst's listening receptivity in the here‐and‐now. The author concludes with a consideration of the importance of Bion's American reception in 1967.     

帕金森病诊断标记物系统回顾与展望

本篇综述总结了帕金森病的诊断、鉴别诊断和病程监测的各领域的生物学标记物的研究进展。其中重点介绍了神经影像学和生物化学领域的生物学标记物,也是当前研究较为成熟的两大领域。神经影像学标记物以多巴胺能影像及非多巴胺能影像为代表,生物化学标记物为包括a一突触核蛋白在内的多种蛋白和激素,两者的结合能够有效提高疾病诊断的特异性和灵敏性。同时文章还介绍了当前研究的热点——帕金森病的前驱诊断手段,即在疾病典型的运动症状和非运动症状出现前便可预测帕金森病的诊断手段。     

13例脐尿管囊肿的诊断分析

脐尿管囊肿是一种少见畸形,为探讨其病因、临床表现及诊治方法,对2010年1月～2013年12月于我院诊断为脐尿管囊肿的13例患者进行回顾性分析。结果显示,脐尿管囊肿主要发现于男性患儿,可表现为腹痛、脐部或膀胱不适等合并症,常伴有发热,也可无明显临床表现,由单纯查体发现。B超和CT是推荐检查方法,确诊需依靠组织病理学检查。手术切除是治疗该病的首选方法,临床效果满意。随着技术的发展,治疗脐尿管囊肿可优先选择腹腔镜切除术。